I got the answer to my life's problems last month. Well, at least that’s what some people would expect, and maybe to an extent a little bit what I expected. I was diagnosed with bipolar II disorder in early January after a few months sitting on NHS waiting lists and a lot more years of being – looking back – obviously fucking bipolar.
Like I said, I expected it to be the answer to my life’s issues, the thing that I could point to and be like “that’s why I felt that way.” It’s been helpful, but it’s not all that. There are so many misconceptions around what bipolar disorder even is, or looks like, or feels like. Really, I can never say any of my life was that way because I’m bipolar; it’s too varied and personal. Instead of talking about how my psychiatrist fixed my life (I’m actually going to talk about some damage my diagnosis has done, not just the good), I just want to talk about my experiences with mental health pre-diagnosis that could’ve pointed to the new diagnosis, the process of getting diagnosed, and where I am now, if that’s alright with you, dear reader.
The first time I remember thinking that there’s “something wrong” was when I was about eleven, having my first panic attacks. Looking back, they were definitely gender dysphoria induced. I would skip classes to go to my mum’s classroom (she was an assistant at my school), hide in the supplies closet, and freak out for reasons I couldn’t explain even to myself. Being a transgender kid was pretty damn traumatising, I think we can all agree. Being put through a puberty that was the exact opposite of what you knew was meant to happen to you would be enough to make anyone spiral into “fuck, I think I’m gonna die, my body isn’t my own.” Life carried on that way for quite some time, until I was around fourteen.
At thirteen or fourteen, maybe I got myself involved in the “wrong crowd.” My home life was, by that point, in shambles. My parents were separated but still living together, queue the domestic abuse. I was completely and utterly emotionally neglected – which I no longer blame my mother for, but probably says a lot about me. I fell into friendships with other kids from troubled homes, and troubled homes often breed troubled kids. Much to my parents’ disbelief (no, literally, they didn’t believe me), I got myself into petty crime and prescription painkillers out of both small-town boredom and a sheer desperation to escape my home life without actually running away. That period was the first time I remember feeling depressed. Without any love or affection at home – only coldness, alcohol, screaming, and more I won’t describe to anyone but my therapist – I was hopeless. Miserable, isolated, I felt like I was watching my future in my parents, and I hated it, I didn’t want a future. For the first time, I started to self harm with anything I could get my hands on. I thought, surely, my parents were ignoring me (other than to abuse me with a variety of methods, known to them or not) because I was simply an unlovable problem child. I was a problem child temporarily, but it was difficult to not be when you’ve got problem parents.
I don’t think I ever really left that depression for the rest of secondary school. My home life didn’t get any better – it actually got worse. A stint of homelessness, worsening of the abuse, and then my dad’s suicide were gut punch after gut punch, I couldn’t get better in those conditions. So much so, that I actually don’t have many memories to recount to you from fourteen to seventeen. The main one I have is, about two months after my dad’s death, begging whatever was listening to give me the will to kill myself, too. Surely a normal kid you “never had to worry about.”
That brings us to the age of eighteen or nineteen. The glorious age of discovering drink-fuelled nights out ending in a kebab shop at 4am, a gorgeous time for most. At the time, it was glorious. I would get so drunk I was sick, dance until the lights came on with my friends, get a kebab, share a taxi back to my village, and wake up at 9am for sixth form or university. I blew all of my savings on those nights, as well as on following tours of bands I really wish I hadn’t. I got tattoos – something I’ve always wanted – but with questionable designs, for sure. I shaved my head. Enough said. All the while, I managed three A* grades in my a-levels, and to leave university after a year with a certificate with distinction in psychology. Wait – leave university after a year?
Following the “making out with strangers in the gay club for party drugs” era, I really started to slip. It was so inexplicable to me. I missed exams, I half-assed everything else, I lost relationships that were important to me because I withdrew so massively, so suddenly. Drinking and drugs became not for fun, but for getting through the day. Takeaway became not a fun continuation of the night, but a necessity so that I didn’t starve without the energy to cook. It culminated one night in April of 2023 where I shoved a handful of pills down my throat, nowhere near enough to kill me, but enough to make me feel like I might be dying.
Needless to say I got put on antidepressants after that. I got 20mg, then 40mg, of citalopram, from my GP. It… “worked.” Meaning, it gave me the physical and mental energy to do things again. Something still wasn’t right though. I was what I can only describe as buzzy and all over the place. I stopped having panic attacks, finally, but through the nine months or so I was on the citalopram, I felt like I was on bad drugs (well, I was). I thought, though, that because I was doing things again, I was fixed, and so I stopped. Never ends well. A few weeks off the meds, and I was right back in a hole of pity and despair.
Citalopram was actually my best experience of a psych drug, weirdly. When I finally accepted that I needed the antidepressants, I went back to my GP, who decided to try 50mg, then 100mg, of sertraline instead. I wish I stuck with the citalopram, because goddamn, I was in a hypomanic episode (unbeknownst to myself) for a year. It wasn’t a productive, happy one either; it was a deeply uncomfortable and destructive one. I was absolutely wired, my sleep schedule was broken, I was beyond irritable. I never shut up, and I blew my savings even more, to the point where I hit zero. They got me back to university, though! When I first came back to studying, I drank like I did at eighteen, felt like I did for the entire year prior. Then, I ran out of my stockpile, and I wasn’t registered with a GP yet – oh well, clearly I was fine and didn’t need the meds anymore!
For a while, I genuinely didn’t need them. I was lonely, yes, but I just didn’t really have friends here yet. I thought I was over it, that the meds had worked. I only retried the sertraline when I started having health anxiety-related panic attacks brought on by endless A&E visits and (relatively mild) agoraphobia. 25mg gave me serotonin syndrome. Whatever, girl. I recovered outside of hospital with some relief from paramedics and stopping the meds, and I didn’t try any more meds after that. I actually swore off antidepressants, and for pretty good reason, I guess. I’d work on myself by myself.
I managed that way relatively well until September 2025. I’d stopped having panic attacks whenever I left my house, largely because my health improved on a gluten free diet. I’d also fallen into a solid friend group, who I now live with, and a stable, supportive relationship of nine months helped, too. Unfortunately, it didn’t last. In September, presumably because of the move into a new house, my routine got much worse. I didn’t have any – I wasn’t working like I was over summer, university hadn’t started yet, and I was in a new house. For three days, I barely slept, I stayed up obsessively writing fanfiction and listening to music. I talked everyone’s ears off for a few days straight, and had a few deeply messy nights of binge drinking. I didn’t even miss the sleep, or the food, or anything; I was just on top of the world. After a few days, though, it catches up to you. On the fourth and fifth days, I couldn’t stop shaking, I had so much energy all I could do was cry and constantly mumble to myself. For God’s sake, I scream-cried in the kitchen while trying to make spaghetti bolognese because I burned my hand, the stove was beeping at me, there were people around me, and the washing machine was on. That was when I knew something was definitely wrong – “normal people” don’t react to change like that. Thankfully, my girlfriend could already see what it was, and she had me start tracking my mood every day, holding me accountable to it, and gave me the courage to get some help.
After an hour on the phone with the NHS’ urgent mental health line, I had a referral to the Community Mental Health Team in my area – a group of nurses, therapists, psychiatrists, and more, who deal with severe adult mental illness. I was hesitant, I knew all too well the way severe mental illness is seen within the NHS and society as a whole, but I was desperate. For three and a half months, now in the most severe depression of my life, I heard nothing. I got nowhere, nothing at all. It took until a repeat of September in early January, this time with some mild psychosis, to get anywhere. One night, I was so amped-up and upset that I couldn’t articulate or identify any of my thoughts. It was just straight word soup in there. Nothing made sense, and it was so distressing that I called the line again, who threatened the police on me if I didn’t walk myself to A&E. I actually did walk there, but a moment of clarity hit me as I walked over the threshold that I was about to get myself sectioned and put in inpatient, and I turned around and walked home. I called the line again so they knew where I was and didn’t send the police. Thankfully, by some absolute miracle, I spoke to the lady who did my initial assessment. A lovely Welsh lady who calls me “cariad” (“love”), who’s a big advocate for harm reduction and just lets me talk for however long it takes. She told me that she understood why I didn’t want to go in, and why I was so upset at having the police threatened on me for being upset when I said I wasn’t a risk to anyone, nor myself. She told me it was wrong. She chased my referral to a psychiatrist up, and apologised for my wait, telling me it was unusual and must have been painful. I felt safe enough in her company to, following her advice, take some drowsy antihistamines I had and get some sleep. We agreed that, tomorrow, if I was still doing that badly, I would go to hospital.
I was awoken the next day by a phone call from the psychiatrist, offering me an urgent appointment two days later. Finally, thank God. I’ve written about the appointment before, so I won’t do it again, it was your typical psychiatrist appointment. At the end, he asked me what I thought the issue was. After I said bipolar disorder, he said he agreed and was going to consult with his colleague who was a specialist in bipolar disorder, then call me and let me know the course of action. The next day, on the bus to a dentist appointment, I got the phone call. I was officially diagnosed with bipolar II disorder, and we were going to get me started on an anti-epileptic drug called lamotrigine that works especially well for bipolar depression.
There’s a lot of ideas about what bipolar disorder is. In psychiatry, which I’m famously a huge fan of, type II is defined as a mood disorder characterised by at least one depressive episode lasting at least two weeks, and at least one hypomanic episode lasting at least four days. In type II, the depression is usually severe – type I doesn’t require it at all. Hypomania, a lesser form of mania, is characterised by things like excessive energy, starting a lot of tasks, talking a lot, engaging in risky behaviour. The key defining feature is that hypomania doesn’t involve a disconnect from reality, or psychosis, mania does. Okay, are we on the same page?
Now that that’s out of the way, I can talk about me and medication. My first trial was with lamotrigine, on a six-week taper up to 200mg. The thing about lamotrigine is that it can, very rarely, make your skin fall off. No, seriously, look it up. I got a rash and noped the fuck out after a week. Absolutely the fuck not, not me. After that, I had a period off meds until I could see my psychiatrist again. Then, we tried aripiprazole, an atypical antipsychotic that gets used quite often for mania, but not so much depression, not on its own. My psychiatrist had hope, though, so I gave it a go on a low dose. I have to give it credit – I didn’t have a hypomanic episode on it, and I could definitely think clearer, and was less paranoid. Bad news, I was still hopelessly depressed. Cut to now, I kept the aripiprazole, but very reluctantly and carefully added fluoxetine. A kids’ dose, which is pretty embarrassing for a grown ass man, but I had serotonin syndrome, okay?! I haven’t been on the combination long enough to know how it affects me yet, but so far, no actual problems. Yay!
Psychiatric drugs, especially neuroleptics like aripiprazole, come with such a stigma attached. There’s a perception of them as extremely heavy drugs for extremely dangerous people. Doctors, in my experience so far, look at you a little bit funny when you tell them you take one. It’s like, in their minds, you’re suddenly not just a patient, but a mad patient. They can be heavy drugs; they’re abused a lot in psychiatric wards (read: prisons), with forced injections and overmedication. They have a horrific history. But, they don’t have to be those things. They can just be drugs, neutrally. For me, that’s what aripiprazole is. It’s just there to keep my thoughts legible, and my mood not too high from the fluoxetine. And damn, it does a good job of it. Not everyone is so lucky, but thankfully, I’m pretty sure I’ve found the antipsychotic for me. Antipsychotics aren’t just used for psychosis, you see, a variety of people can and do use them.
Yet another misconception, probably born from “the weather’s so bipolar today,” or maybe the similarity in acronyms between bipolar disorder and borderline personality disorder (how did these two really end up so muddled?), is that bipolar disorder involves rapid mood swings. Even in “rapid cycling” bipolar, the criteria is four or more episodes in a year. Sure, they can go quickly, but it’s not within a day – more on this in a little bit. It’s a long, gruelling process of going through a mood episode. They can last months, even years, and it’s an extended, drawn out form of, honestly, torture. But as mentioned, I’m not a ride or die for psychiatry (I’d sooner die than ride at all), so take that with a grain of salt. But, generally, that’s not the experience that the label ‘bipolar’ relates to.
Especially being diagnosed with bipolar II, there’s this lingering idea that it “isn’t bad enough,” which often leaves people undiagnosed, or misdiagnosed, commonly with depression and/or BPD. Because hypomania is a lesser form of mania, you’re not seen as “manic enough” or “sick enough.” This, obviously, comes with some societal privilege over people diagnosed with bipolar I. But, it’s a misconception in its own right. In bipolar II, depression is what’s referred to as “the burden of the disease.” Depression for us is often severe, long-lasting, relapsing, and statistically comes with a higher rate of suicidal behaviours. Sucks. Hypomania isn’t fun either – it can seem it in the moment, but it can be even physically unpleasant at times, too. Not sleeping, not eating, forgetting basic bodily functions, engaging in a lot of sex, drugs, and alcohol, oftentimes doesn’t do great things for your physical health.
Following the “it’s not bad enough” line some more, I’ve often heard something along the lines of “well, you weren’t bipolar before.” Yeah, I wasn’t, because that’s not how it works! Similar to schizophrenia, symptoms of bipolar disorder on average show up between the ages of fifteen and twenty five, when major life changes and stressors tend to happen to someone for the first time – graduating, moving out, et cetera. Keeping on that same line, bipolar disorder doesn’t mean you’re always depressed, or always (hypo)manic. Most people have periods of euthymia – a “fine” mood. There’s also mixed episodes, where someone has symptoms of hypomania and depression at the same time, or in quick succession, e.g. switching around over the course of days rather than weeks/months. I struggle with these a lot, and I find them much worse than depression or hypomania alone. Being depressed but with the energy to do something about it is a deeply unpleasant and often unsafe combination. For me, mixed episodes feel like I’m on a really bad trip. I’m absolutely miserable, I need to do something about that, but my thoughts race a million miles an hour, and I can’t stop doing stuff, I can’t stop talking about how miserable I am, I’m beyond irritable. This, to me, is the worst part of bipolar disorder. Thank fuck for aripiprazole, dude.
Hopefully, it’s all coming to a pause for me now. It won’t ever go away, probably, not because it makes me inherently sick or broken, but because that’s just how life is, I guess. I wish it wasn’t, but I’ve been dealt my cards, and now I just have to deal with the hand I’ve got. That’s just it – I have to deal with it. I do what I can. I take my meds, since I want them. I wait for some more therapy, not because I necessarily want it, but to keep my doctors happy. I find joy where I can, even on the worst days when I don’t actually feel the joy at all. I talk to others who understand, and those who don’t, to try and get them to to the extent that they can without experiencing it themselves. I learn as much as I can about those who came before me, the torture they endured (and continue to), and my mad siblings who are less fortunate than myself in their experiences with mental illness and psychiatry. If I can make one person understand what it’s like to live like this, and to listen to us when we talk about our experiences rather than shutting us away and turning us to the carceral system, then it’ll be worth it. It’ll be worth the meds trials, the mood swings, the awkwardness of being open, and the social (sometimes physical) violence of doing so in a world that really doesn’t want mad people to speak.
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